Coaching Questionnaire
The purpose of this form is for us to discover the vision and value of what you could attain out of our working together.

A few guidelines:

Answer as much or as little as you'd like.
Be as detailed as you'd like, yet don't "stress" about doing this "right."
Our confidentiality begins now. Share freely.
You'll get an email after with your responses.

I'm looking forward to seeing how I can best support you.

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Email *
First & last name *
Pronouns (she/her, they/them, etc)
What would you like me to know about you?
How did you hear about this? Specifically from where or whom? *
If nothing were in the way, what would you most want to achieve in working together?  (Where would you be experiencing satisfaction, meaning, and fulfillment? What goals and dreams would you be attaining?) *
Where are you now in relation to these goals and dreams?  (What is working or not working currently? Where might there be an opportunity for learning, growth, or breakthrough?) *
What do you hope to achieve through coaching that you might not otherwise? *
What are you looking for in the person you choose to work with?  (What would you LOVE to be present in the person you choose to work with? i.e. "I'm looking for someone who... has certain qualities, takes a particular approach, has a specific area of experience, really "gets" a particular context, etc") *
Are you able to afford coaching?  I currently offer a sliding scale with 3 tiers: $175 / $200 / or $225 per month.  For the first month of working together, I offer 4 sessions get started, followed by 2 sessions a month with unlimited email and text support. *
Any questions to see if we are a fit?  Anything else you'd like to say?  
A copy of your responses will be emailed to the address you provided.
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